METHOD FOR SELECTING SURGICAL APPROACHES TO PATIENTS WITH HIP JOINT DISEASES AND INJURIES Russian patent published in 2015 - IPC A61B5/00 

FIELD: medicine.

SUBSTANCE: "orthopaedic index" is calculated as a sum of three values. The first value is derived by conducting densitometry, and points are assigned according to its findings: 1 point for norm, 2 points for osteopenia, 3 points for osteoporosis, and 4 points for severe osteoporosis. The second value is derived by means of Charlson comorbidity index; 0-2 points according to the Charlson comorbidity index scale correspond to 1 point of the second value; 3 points of the Charlson comorbidity index scale are 2 points of the second value; 4 points of the Charlson comorbidity index scale show 3 points of the second value, while 5 points and more of the Charlson comorbidity index scale correspond to 4 points of the second value. The third value is determined by assessing the quality of life as per the scales SF-36; 0-200 points according to the scales SF-36 correspond to 4 points of the third value; 201-400 points of the scale SF-36 show 3 points of the third value; 401-600 points of the scales SF-36 provide 2 points of the third value, and 601-800 points correspond to 1 point of the third value. Total score is deriving by summing up the three values to determine "the orthopaedic index": I - 1-3 points, II - 4-6 points, III - 7-9 points, IV - 10-12 points. The form of treatment is defined: the patients with index I have the endoprosthesis replacement with endoprostheses with a shortened leg of the femoral component, the greater diameter of the head (36 mm or more); the patients with index II have the endoprosthesis replacement with cementless anchored total endoprostheses; the patients with index III have the total hip replacement with cemented endoprostheses; the patients with index IV have the endoprosthesis replacement with cemented anchored bipolar endoprostheses.

EFFECT: through assessing the available factors influencing the postoperative period, prosthesis anchoring in its bed, potential endoprosthesis rejection, functional effect and potential aggravation of comorbidities, the method can improve functional outcomes, reduce the risk of endoprosthesis loosening and the risk of recurrent operations.

2 ex